BNF for Children

8th October 2024

BNF for Children

This update contains 10 significant changes, 2 dose changes, 1 new monograph and 1 new preparation.

Significant Changes:

• Borderline substances: enteral (tube) feeds have been re-organised in a new section called Enteral nutrition.
• Cholera vaccines: updated guidance for immunisation.
• Epimax® ointment and Epimax® paraffin-free ointment: reports of ocular surface toxicity and ocular chemical injury [MHRA/CHM advice] (advice in emollient creams and ointments, paraffin-containing and emollient creams and ointments, hydrogenated castor oil-containing).
• Human papillomavirus vaccine: updated guidance for immunisation.
• Immunisation schedule: updated guidance.
• Poisoning, emergency treatment: updated guidance for paracetamol overdose.
• Sacubitril with valsartan: update to dose expression.
• Sodium valproate: new precautionary advice for male patients [MHRA/CHM advice].
• Status epilepticus: updated guidance for management.
• Valproic acid: new precautionary advice for male patients [MHRA/CHM advice].

Dose Changes:

• Human papillomavirus vaccine [update to dosing].
• Levonorgestrel [update to indications and dose for intra-uterine devices].

New Monographs:

• Emollient creams and ointments, hydrogenated castor oil-containing.

New Preparations: Aqumeldi® [enalapril maleate].

10th September 2024

BNF for Children

This update contains 5 significant changes, 4 dose changes, 1 new preparation, 1 deleted monograph and 2 deleted preparations.

Significant Changes:

• Carbamazepine (Tegretol® 100 mg/5 mL Liquid): temporary stock-out and update to posology (reduction of maximum daily dose) [MHRA/CHM advice].
• Drugs that cause sedation and drugs with CNS depressant effects: pharmacodynamic effects drug groups combined and renamed as drugs with CNS effects; see Interactions.
• Gonadotrophin-releasing hormone analogues: new restrictions on use for puberty suppression (see example in gonadorelin).
• Topiramate (Topamax®): introduction of new safety measures, including a Pregnancy Prevention Programme [MHRA/CHM advice].
• Warfarin sodium: be alert to the risk of drug interactions with tramadol [MHRA/CHM advice].

Dose Changes:

• Calcium gluconate [update to dosing for acute severe hyperkalaemia].
• Ivacaftor with tezacaftor and elexacaftor [update to dosing].
• Lebrikizumab [update to dosing].
• Rosuvastatin [update to dose adjustments due to interactions with belumosudil].

New Preparations: Ivermectin.

Deleted Monographs: Colecalciferol with calcium phosphate.

Deleted Preparations: Creon 40000® [pancreatin]; Pancrease HL® [pancreatin].”

13th August 2024

BNF for Children

This update contains 4 significant changes, 1 dose change, and 3 new monographs.

Significant Changes:
•Immunisation schedule: updated guidance for immunisation against influenza.
•Influenza vaccine: updated guidance for immunisation.
•Medical emergencies in the community: updated guidance on the use of salbutamol in the management of acute asthma.
•Topical corticosteroids: introduction of new labelling and a reminder of the possibility of severe side effects, including Topical Steroid Withdrawal Reactions [MHRA/CHM advice] (advice in relevant monographs; see example in betamethasone).

Dose Changes:
•Salbutamol [update to dosing for asthma; prophylaxis of allergen-or-exercise-induced bronchospasm; and exacerbation of reversible airways obstruction].

New Monographs:
•Biktarvy® [bictegravir with emtricitabine and tenofovir alafenamide].
•Finlee® [dabrafenib].
•Spexotras® [trametinib].

9th July 2024

BNF for Children

This update contains 7 significant changes, 1 new preparation, and 1 deleted monograph.

Significant Changes:

• Borderline substances: products suitable for additional energy, protein, or fibre requirements have been moved to a new section called Energy, protein, and fibre fortifiers.
• Co-codamol: update to dose expression.
• Combined hormonal contraceptives: update to breast-feeding advice (see example in ethinylestradiol with norethisterone).
• Dabigatran etexilate: Direct-acting oral anticoagulants (DOACs): paediatric formulations [MHRA/CHM advice].
• Ear: updated guidance for the removal of ear wax.
• Intra-uterine contraceptive devices (copper): name change of Novaplus T 380® Ag to Eurogine T 380® Ag, and name change of Novaplus T 380® Cu to Eurogine T 380® Cu.
• Montelukast: reminder of the risk of neuropsychiatric reactions [MHRA/CHM advice].

New preparations:

• Pradaxa® oral granules [dabigatran etexilate].

Deleted Monographs:

• Soybean oil.

11th June 2024

BNF for Children

This update contains 4 significant changes, 5 dose changes, 5 new monographs and 1 deleted monograph.

Significant Changes:

• Borderline substances: products suitable for conditions requiring a ketogenic diet have been moved to a new section called Ketogenic diet.
• Diabetic hyperglycaemic emergencies: updated guidance for management of individuals aged 16-18 years.
• Gentamicin : removal of indication and dose for treatment of Pseudomonal lung infection in cystic fibrosis.
• Meningococcal vaccines: updated guidance for immunisation.

Dose Changes:

• Amikacin [update to dosing for pulmonary infection with Pseudomonas aeruginosa in cystic fibrosis].
• Bexsero® ( meningococcal group B vaccine (rDNA, component, adsorbed) ) [update to dosing].
• Cyanocobalamin [update to dosing].
• Haemophilus influenzae type b with meningococcal group C vaccine [update to dosing].
• Meningococcal groups A with C and W135 and Y vaccine [update to dosing].

New Monographs:

• Adacel® [diphtheria with tetanus and pertussis vaccine].
• Entresto® [sacubitril with valsartan].
• Opdivo® [nivolumab].
• Opdualag® [nivolumab with relatlimab].
• Velsipity® [etrasimod].

Deleted Monographs:

• Artenimol with piperaquine phosphate.”

14th May 2024

BNF for Children

This update contains 8 significant changes, 3 dose changes, 3 new monographs, 1 new preparation and 2 deleted monographs.

Significant Changes:

• Budesonide: update to dosing for modified-release capsules.
• Codeine phosphate linctus (codeine oral solutions): reclassification to prescription-only medicine [MHRA/CHM advice].
• Hydrocortisone: updated indication oral and perioral lesions to aphthous ulcers.
• Hyoscine butylbromide: update to important safety information.
• Malaria, prophylaxis: updated guidance.
• Pneumococcal vaccine: updated guidance for immunisation.
• Pseudoephedrine hydrochloride: very rare risk of posterior reversible encephalopathy syndrome (PRES) and reversible cerebral vasoconstriction syndrome (RCVS) [MHRA/CHM advice].
• Vaccination, general principles: updated guidance for immunisation of individuals with asplenia, splenic dysfunction, or complement disorders.

Dose Changes:

• Acetylcysteine [update to dosing for paracetamol overdosage].
• Paracetamol [update to upper weight range for intravenous paracetamol].
• Pneumococcal polysaccharide conjugate vaccine (adsorbed) [update to dosing].

New Monographs:

• Enspryng® [satralizumab].
• Evkeeza® [evinacumab].
• Eylea® [aflibercept].

New Preparations: Otinova® [aluminium acetate].

Deleted Monographs: Chloroquine with proguanil; Proguanil hydrochloride.